Comparative effects of lercanidipine, amlodipine and hydrochlorothiazide on 24-hour ambulatory blood pressure and leg edema in confirmed ambulatory hypertensive patients
Bibliographic record
Abstract
Lercanidipine (LER) is a dihydropyridine calcium antagonist having shown a lower incidence of leg edema in comparison with its congeners. The objectives of this study were to compare the effects on 24-hour ambulatory blood pressure (BP) as well as on the magnitude of leg edema of treatments using LER, amlodipine (AML), or hydrochlorothiazide (HCT) in patients with confirmed ambulatory hypertension (daytime systolic BP >135mmHg). A total of 121 eligible patients (66M/55F, mean age of 62.7±7.1 yrs) were randomized to either LER 10 mg (n=39), AML 5 mg (n=39) or HCT 12.5 mg (n= 43) for 4 weeks. They were then force-titrated to LER 20 mg, AML 10 mg and HCT 25 mg for 4 weeks of treatment. Ambulatory BP monitoring was performed at baseline and after each of the 4-week treatment period (week 4 and 8). The magnitude of leg edema was evaluated using the leg volume measured by water deplacement volumetry at the same timepoints both in the morning at trough and in the afternoon. Daytime ambulatory systolic/diastolic BP were comparable for the LER (150.0/88.6 mmHg), AML (153.2/88.7 mmHg) and HCT (151.8/86.5 mmHg) treatment groups at baseline. Mean daytime systolic/diastolic BP (mm Hg) were reduced by treatments with LER (−3.4/−0.9 and −5.6/−2.1), AML (−10.2/−4.7 and −17.4/−9.2) and HCT (−3.9/−1.3 and −6.8/−3.5) at week 4 and week 8, respectively. However, LER induced BP decrements significantly (p<0.001) less pronounced than those obtained after AML treatment but comparable to HCT treatment. Changes in leg volume were significantly (p<0.05) more important with AML in the morning as compared with LER at week 4 (+27.6 vs -39.2 ml) and at week 8 (+128.0 vs -19.0 ml). Similarly, leg volumes with AML as compared with LER were significantly different at week 4 (+21.6 vs -2.6 ml) and week 8 (+138.0 vs +36.3 ml), as measured in the afternoon. HCT decreased leg volume in the morning and in the afternoon at week 4 (-22.6 and -0.8 ml) and at week 8 (−47.6 and −11.1 ml), respectively. The results of the present study demonstrate that the dihydropyridine calcium antagonist LER induced significantly less leg edema than AML but similarly to HCT as measured by leg volume. However, this beneficial effect of LER was associated with significantly less antihypertensive efficacy on ambulatory BP as compared with AML.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".